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Drugs That Affect
Bone Health
Are your medications
wreaking havoc on your
bones?
By Angela S. Hoover, Staff Writer
Preserving bone health is a concern for everyone, but even more so
for individuals with osteoporosis or
those who are at risk for it. While
some medications are good for the
bones, others can have negative side
effects on healthy bones. In these
scenarios, it’s best to consider the
pros and cons of any medication
that could damage bone health.
Sometimes a bone-maintenance drug
can be prescribed to offset the risk if
the other medication must be continued. Here are some classes of drugs
that affect bone health:
Antidepressants
Anti-Cancer Drugs
Bone Maintenance
Drugs
Aromatase inhibitor drugs
are given to some breast cancer
patients. These include anastrozole
(Arimidex), exemestane (Aromasin)
and letrozole (Femara). They target the body’s aromatase to lower
estrogen levels in an effort to halt
estrogen-fueled cancers. However,
lowering estrogen levels can be bad
for the bones because estrogen stops
bone resorption. Men being treated
for prostate cancer are sometimes
prescribed anti-androgen therapy
that includes the drugs bicalutamide
(Casodex), flutamide (Eulexin) and
nilutamide (Nilandron). These drugs
block the action of testosterone in an
effort to slow prostate cancer growth,
but they can decrease bone density
and increase fracture risk.
SSRI antidepressants such as citalopram (Celexa), fluoxetine (Prozac),
paroxetine (Paxil) and sertraline
(Zoloft) increase the risk of fractures
for those who take them. In fact, a
study found that those taking SSRI
antidepressants were twice as likely to
have a fracture than those not taking
an SSRI. Another study found that
women with a history of depression
who had taken SSRIs had lower bone
density compared to those who did
not take an SSRI.
In an ironic twist, certain bonemaintenance drugs can cause a
greater chance of an uncommon
fracture of the thigh bone after
long-term use. Bisphosphonates, a
type of osteoporosis drug, include
alendronate (Binosto and Fosamax),
ibandronate (Boniva), risedronate
(Actonel and Atelvia) and zoledronic
acid (Reclast). If someone has been
taking a bisphosphonate for five
years, the person should check with
his or her doctor about switching
to another bone-maintenance drug.
Safer alternative drugs for osteoporosis and bone maintenance include
denosuman (Prolia